Laparoscopy-assisted Distal Gastrectomy should become a Standard Surgical Treatment Option for Stage IA/IB Gastric Cancer

摘要

Gastric cancer (GC) is one of the most commonly occurring and deadly cancers in the world,1especially among Chinese.23In the early stages of GC, surgery with either subtotal or total gastrectomy, is the first treatment option. Current guidelines recommend open distal gastrectomy (ODG) with D2 lymph node dissection as the standard treatment for stage I GC.45However, laparoscopy-assisted distal gastrectomy (LADG), a minimally invasive technique, has become more widely adopted as it results in fewer blood loss, lower pain, and faster recovery than ODG.67Previous retrospective studies have reported there were no statistically significant differences in the overall survival of GC patients receiving LADG and those receiving ODG.89But selection bias might arise in these studies, because LADG is much more difficult than ODG. Therefore, it is necessary to determine whether LADG is good enough to replace ODG in the treatment of early-stage GC through randomized controlled, noninferiority clinical trials.